Though diabetes treatment and prevention have improved in recent years, EU member states are too slow when it comes to proper implementation and monitoring of policies. This means that Europe is losing the battle against the growing diabetes epidemic, according to a new study.
The report, Diabetes in Europe: The Policy Puzzle – The State We Are In, published by the European Coalition for Diabetes reveals that more countries have a national diabetes register (30 out of 47) and that a large majority of European countries have also taken steps to tackle the burden of diabetes at policy level.
However, the report also shows that 83% of the national registers are incomplete. When it comes to national plans covering diabetes, implementation and monitoring appear to be major weaknesses. The Czech Republic is the only country in the region that includes a strong monitoring and evaluation system in its national plan. It is also the only country to assess the cost effectiveness of the measures within its plan.
“In the current context where politicians across Europe repeatedly stress the need to reduce health expenditure and make healthcare systems more sustainable, it is alarming to see that cost-effectiveness analysis of policies is almost absent,” said Anne-Marie Felton, co-chair of the steering committee of the report.
When it comes to prevention, all but two countries have adopted prevention policies addressing the main risk factors of diabetes, including obesity and lack of physical activity and Greece is the only country that reports monitoring and measuring the impact of its prevention policies, as well as assessing their cost-efficiency.
“Sadly, we see that prevention also remains poorly funded throughout Europe,” said Felton. “This is a lost opportunity here, as over 70% of type 2 diabetes cases can be prevented or delayed by adopting healthier lifestyles.”
The burden of diabetes in Europe is growing, with 52 million people now living with diabetes in the region. One in three adults with diabetes is undiagnosed, meaning that many people already have at least one complication by the time they are diagnosed.
In 20 years’ time, estimates indicate that more than one in ten adults in Europe will have diabetes, if nothing is done to reverse the epidemic. Together with Europe’s ageing population, diabetes will lead to spiraling healthcare costs and place a severe strain on national health systems.
“Inaction is clearly not an option,” said Michael Hall, honorary consultant to the International Diabetes Federation European Region.
“The first step for governments to improve diabetes care is to increase their efforts to establish national strategies for diabetes, with full implementation and regular monitoring. This would also allow for better use of resources, which is essential if countries are to build a successful response to the diabetes epidemic in Europe.”
Every two minutes, an EU citizen dies of diabetes-related diseases, according to the European Diabetes Leadership Forum (EDLF), a stakeholder organisation initiated by pharma company Novo Nordisk, ?which aims to move diabetes up the public health agenda.
50% of all people with diabetes die of cardiovascular disease, making diabetes the fourth most common cause of death in Europe, EDLF figures show. Meanwhile, 10-20% die of kidney failure, 10% develop severe visual impairment and 50% suffer from diabetic neuropathy, it says.
However, governments are not whole-heartedly engaging in effective measures to curb obesity, according to the European Centre for International Political Economy (ECIPE), a think tank. This is despite calls from the World Health Organisation (WHO) and the Organisation for Economic Co-operation and Development (OECD) among others, to halt and revert obesity trends, which are driving diabetes.
In a policy document from 2013, the ECIPE says special attention should be paid to diabetes, which is considered a chronic disease linked to heart problems and strokes. Around 9.3% of the EU's total health budget is spent on diabetes.
Diabetes is caused by a lack of insulin, due to insufficient pancreatic production or high blood sugar levels. It can also develop from insulin resistance, a case where the pancreas produces insulin that is rejected by the body.
EU member states have been experimenting with measures to prevent obesity and excessive weight gain, which cause 'type 2' diabetes.
Such measures include those suggested by the OECD: food education and physical activity at school level, or food taxes targeting food products with high content of sugar or saturated fat.
“On current trends, and if no changes are made to the healthcare coverage, governments in Europe will soon be facing rapidly increasing costs related to the treatment of illnesses and health problems associated with obesity,” the ECIPE said.
- 14 Nov.: World Diabetes Day.
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